Dynamic Glucose Management

MATCH: Prevent Lows with Precise Glucose Dosing

Preventing and treating hypoglycaemia using glucose — not sugar — with the dose matched to where you are and how fast you are falling.

Dynamic Glucose Management Hypoglycaemia Hypo treatment

What is MATCH?

MATCH is the Prevent Lows pillar of Dynamic Glucose Management. The mechanism: prevent and treat hypoglycaemia with glucose (not sugar), and match the dose of glucose to your current level and your rate of fall.

This matters because over-treating hypos — or using sugar — often creates the same rollercoaster: low → panic eating → rebound high → correction → repeat.

Two principles to hold onto:

The gut maxes out at about 1 gram of glucose absorbed per minute.
It takes roughly 20 minutes for a treatment to show up clearly on CGM.

The skill is not perfection. It is fast feedback: dose, wait, read the curve, then adjust next time.

Video overview: preventing and treating hypos

Watch: MATCH — Preventing and treating hypoglycaemia (YouTube)

Why sugar tends to be a poor choice for hypo treatment

The key mechanism: half the grams in sugar are fructose, and fructose is stored in the liver rather than entering the bloodstream directly. So roughly only half of a sugar-based treatment actually addresses the hypoglycaemia.

Diagram showing how fructose in sugar gets stored in the liver rather than raising blood glucose directly

This is exactly why some people end up needing repeated treatments — and then often rebound straight back up high.

CGM trace showing the classic sugar rollercoaster: repeated hypo treatments followed by rebound high

This pattern — the sugar rollercoaster — is something many people recognise before discovering Dynamic Glucose Management.

Dynamic Glucose Management diagram stage 9 showing the glucose rollercoaster pattern

There is a second mechanism worth understanding: flooding the liver with fructose can activate pathways that promote hunger and overeating — compounding the difficulty of accurate hypo management.

Rick Johnson’s research on sugar and metabolic signalling (Peter Attia podcast)

Diagram showing the cascade effect of sugar treatment: slow correction, repeat dosing, fructose storage, rebound high

Sugar creates a compounding pattern: slow correction + repeat dosing + liver fructose = rebound highs and hunger dysregulation.

Why glucose works better

Pure glucose enters the bloodstream directly without the fructose diversion. The absorption is faster, more predictable, and the dose-response is easier to calibrate.

Diagram showing how pure glucose is absorbed directly into the bloodstream for fast, predictable hypo treatment

Two principles that inform the MATCH approach:

The gut maxes out at about 1 gram of glucose absorbed per minute.
It takes roughly 20 minutes for a treatment to show up clearly on CGM.

Diagram showing glucose treatment kinetics: direct absorption, predictable rise, cleaner recovery

Swapping sugar drinks for dextrose tablets is a change many people find makes hypo management more predictable.

CGM trace showing more controlled glucose recovery using dextrose tablets instead of sugar

After switching to Dynamic Glucose Management, many people find they stop needing repeat treatments.

Dynamic Glucose Management diagram stage 10 showing improved glucose stability after switching to glucose treatment

Ready to explore MATCH in depth?

MATCH introduces the idea of adjusting glucose dose based on where you are and how fast you are falling. Not all hypoglycaemic episodes are the same, and they tend not to respond identically to the same dose.

Adjusting hypo treatment dose by glucose level and rate of fall

MATCH summary diagram showing dose adjustment based on current glucose level and rate of fall

Watch: MATCH — Adjusting hypo treatment dose by level and rate of fall (YouTube)

How dose adjustment tends to work in practice

The new idea in MATCH is adjusting your glucose dose based on where you are and how fast you are falling.

For example: a heavier adult might have a typical full treatment of around 18 g (six dextrose tablets). If glucose is 5.5 mmol/L (100 mg/dL) and just starting to fall, they might take around 50%. If glucose is at the same level but falling rapidly, they might take the full amount.

A smaller child might have a typical full treatment of around 6 g (two tablets). If glucose is 3.5 mmol/L (65 mg/dL) and just falling, they might take around 75%. If falling rapidly, they might take around 125%.

MATCH table showing example glucose dose adjustments by current level and rate of fall, using dextrose tablets

Then comes the hardest part: wait 20 minutes before deciding on a second treatment. That is how long it typically takes for glucose to absorb and register on CGM.

Will this work perfectly every time?

No. The MATCH framework is a solid guide for most people most of the time, but type 1 diabetes is highly individual and every hypoglycaemic episode has a backstory. Factors that can change the response significantly include:

How much bolus insulin is still circulating
Activity or exercise in the past 3 hours
Heat and humidity
How many hypoglycaemic episodes have occurred in the last 24 hours
Many other variables that interact in ways that are not always predictable

The skill develops through the feedback loop: dose, wait, read the curve, adjust next time. The Glucose Never Lies.

Exploring MATCH with your CGM data

This content is for educational exploration only. It describes average responses and general principles. It is not medical advice and cannot replace individual clinical guidance from your diabetes care team.

The dose examples in MATCH describe average patterns. Your full treatment dose, and how it scales with glucose level and rate of fall, will depend on individual factors including weight, current insulin sensitivity, and history of hypoglycaemia. These are worth discussing with your diabetes care team before applying them.

Prevent Lows – MATCH